Butson Macinley, Carroll Susan, Butson Martin, Hill Robin
The Illawarra Grammar School, Mangerton, NSW, Australia.
Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, Australia.
J Appl Clin Med Phys. 2017 Sep;18(5):220-224. doi: 10.1002/acm2.12158. Epub 2017 Aug 11.
During breast radiotherapy treatment, the contralateral breast receives radiation doses to the skin and subcutaneous tissue caused mainly from incident electron contamination and low energy photon scatter radiation. Measurements have shown that for a typical hybrid tangential treatment, these dose levels can be up to 17% of maximum applied prescription dose if no shielding is used during the treatment process. This work examined the use of different shielding metals, aluminum, copper, and lead to reduce peripheral radiation dose to evaluate the optimal metal to form the basis of a contralateral breast radiation shield. This work also shows a simple but novel method to substantially reduce this unwanted radiation dose with the use of a copper scale maille sheet which can be easily and accurately draped over a patient's contralateral breast during treatment. The copper scale maille is flexible and can thus conform around typical breast shapes. It can also form irregular shaped edges to match those outlined by typical tangential treatment fields. As the shield is made from copper, it is nontoxic and can potentially be used directly on patients for treatment. The designed copper scale maille has shown to reduce contralateral breast skin and subcutaneous dose by up to 80% for typical radiation fields used in breast radiotherapy.
在乳腺癌放疗过程中，对侧乳房会受到主要由入射电子污染和低能光子散射辐射导致的皮肤和皮下组织辐射剂量。测量结果表明，对于典型的混合切线治疗，如果在治疗过程中不使用屏蔽，这些剂量水平可达最大应用处方剂量的17%。本研究考察了使用不同的屏蔽金属，如铝、铜和铅，来降低周边辐射剂量，以评估形成对侧乳房辐射屏蔽基础的最佳金属。这项研究还展示了一种简单而新颖的方法，即使用铜制锁子甲片，在治疗期间可以轻松且准确地覆盖在患者的对侧乳房上，从而大幅降低这种不必要的辐射剂量。铜制锁子甲具有柔韧性，因此可以贴合典型的乳房形状。它还可以形成不规则形状的边缘，以匹配典型切线治疗野勾勒出的边缘。由于屏蔽由铜制成，它无毒，并且有可能直接用于患者治疗。对于乳腺癌放疗中使用的典型辐射野，所设计的铜制锁子甲已显示可将对侧乳房皮肤和皮下剂量降低多达80%。
